Too Much Stress Can Lead to Depression

 

I listened to a National Public Radio segment about the connection between playing NFL football and brain trauma.

One retired running back said that each time he was hit when carrying the ball it was “like being in a high-impact car accident”. What a tremendous cost to pay, I thought.

For many of us, daily life is so demanding and stressful that it’s like being in a series of high-impact “stress collisions”. The word “stress” doesn’t even seem to do justice the corrosive experience of so much stress. “Trauma” is more like it.

This trauma isn’t the type inflicted by bone-jarring hits during a football game — it’s psychological, though no less real.

Psychiatrist Mark Epstein, M.D., author of the book The Everyday Trauma of Life, writes in a recent New York Times article,

“Trauma is not just the result of major disasters. It does not happen to only some people.

Diving Into Hell: A Powerful Memoir of Depression

From The New York Times, book reviewer and best-selling author Andrew Solomon writes, “Not so long ago, the mere fact of writing that you had suffered from depression conferred a badge of courage, but such confessions have devolved into a dull mark of solipsistic forthrightness. Famous people use such disclosures to persuade you that they are just like you, perhaps even more vulnerable; it’s a way of compensating for the discomfort attached to their glamor. Indeed, in an increasingly stratified world, people with any modicum of privilege may reveal their depression as an assertion of their common humanity. Clinical misery has taken over from death as the great equalizer. Vanity of vanities, all is depression. Into this morass daringly comes Daphne Merkin with the long-awaited chronicle of her own consuming despair, ‘This Close to Happiness: A Reckoning with Depression.'” Read the entire article here.

Should I Tell My Students I Have Depression?

From The New York Times, Abby Wilkerson writes: “The new class I was teaching — “Composing Disability: Crip Ecologies” — was one of several first-year writing seminars offered at George Washington University. Given the focus, it was likely to be a challenge for at least some of the students. And it was presenting a particular challenge to me. Even before the class began, I was anxious. I have depression, and I wondered: Should I acknowledge it in the class? Would the students benefit if I did? I wanted to be sure I knew what I was doing, for everyone’s sake, before taking the leap. But I was not at all certain. The idea of disclosing in the classroom made me feel conflicted and vulnerable.” Read the rest of the story.

How Exercise Might Help Keep Depression at Bay

The New York Times reports that a review of by scientists of studies about exercise and depression showed that exercise, especially if it is moderately strenuous, such as brisk walking or jogging, and supervised, so that people complete the entire program, has a “large and significant effect” against depression, the authors wrote. People’s mental health tended to demonstrably improve if they were physically active. Read the rest of this article.

How Exercise May Help the Brain Grow Stronger

The New York Times reports that a new study with mice fills in one piece of that puzzle. It shows that, in rodents at least, strenuous exercise seems to beneficially change how certain genes work inside the brain. Though the study was in mice, and not people, there are encouraging hints that similar things may be going on inside our own skulls. Read the News

Book Review: ‘Ordinary Well: The Case for Antidepressants

Dr. Abigail Zuger writes in The New York Times, “Dr. Kramer’s bottom line is well summarized by the double meaning of “Ordinarily Well: The Case for Antidepressants” — he argues that antidepressants work just about as well as any other pills commonly used for ailing people, and that the drugs keep people who take them reasonably healthy.” Read the News

The Trauma of Stress in the U.S. and its Connection to Depression

The NFL football draft just happened. I followed it because I’m a lover of the game.

I played as a kid. I now watch the games on TV with my other brother, Wally over pizza, hot chicken wings and lots of libations.  It’s almost a religious experience, full of pageantry, mystery and a sense of belonging that we feel as fans.

football collision

But as I grow older, my passion is tempered by news of the devastating toll playing such a violent game has on players.

I read a news piece a few days ago about former NFL player Brian Schaefering who played pro ball for five years.  He started a Gofundme page to raise $3000 to buy a service dog to assist him with stability issues resulting from the traumatic brain injury he sustained playing football.  Wow.

Jerome Bettis, a retired running back from the Pittsburgh Steelers, said that each collision he suffered during a game “was like being in a car accident.” What a tremendous cost to pay, I thought.

For many of us, daily life is so demanding and stressful, that, like a football player, it’s like being in a series of car accidents. The word “stress” doesn’t even seem to do justice the corrosive experience of so much stress– “trauma” is more like it.

The trauma isn’t the type inflicted by bone jarring hits during a football game, but it’s no less real – and can be disastrous for our physical and mental health.

trauma

In his book, The Everyday Trauma of Life, psychiatrist Mark Epstein writes in a recent New York Times article,

“Trauma is not just the result of major disasters. It does not happen to only some people. An undercurrent of trauma runs through ordinary life, shot through as it is with the poignancy of impermanence. I like to say that if we are not suffering from post-traumatic stress disorder, we are suffering from pre-traumatic stress disorder. There is no way to be alive without being conscious of the potential for disaster. One way or another, death (and its cousins: old age, illness, accidents, separation and loss) hangs over all of us. Nobody is immune. Our world is unstable and unpredictable, and operates, to a great degree and despite incredible scientific advancement, outside our ability to control it.”

Such trauma not only impacts our psychological/emotional and spiritual selves, but our physical brains.

brain

In a brilliant article in the Wall Street Journal, Stress Starts Up The Machinery of Major Depression, Robert Sapolsky, Ph.D., points out that there are many factors that increase our risk of major depression including genes, childhood trauma, and endocrine and immunological abnormalities.

But stress is a frequent trigger.

Sapolsky writes, “The stress angle concerns ‘anhedonia,’ psychiatric jargon for ‘the inability to feel pleasure.’ Anhedonia is at the core of the classic definition of major depression as ‘malignant sadness’”.

As a person who has a genetic history of depression in his family and childhood trauma, I was drawn into Sapolsky’s article. What was the connection between stress and the malignant sadness I’ve experienced off and on since being diagnosed with depression twelve years ago?

Who would have thought that rat brain research would help me understand the link?

Sapolsky gives us a little background about our brain structure by letting us know that our abilities to anticipate, pursue and feel pleasure revolve around a neurotransmitter called dopamine in a region of the brain called the nucleus accumbens. Then he turns to the rats for further illumination:

“Put a novel object – say, a ball – in a mouse’s cage. When the mouse encounters the ball and explores it, the arousing mystery, puzzle and challenge cause the release of a molecule in the nucleus accumbens called CRF, which boost dopamine release. If an unexpected novel object was a cat, that mouse’s brain would work vey differently. But getting the optimal amount of challenge, what we’d call ‘stimulation,’ feels good.”

We humans need just enough challenge and stress to make life interesting.

“CRF mediates this reaction: Block the molecule’s actions with a drug, and you eliminate the dopamine surge and the exploration,” writes Sapolsky. “But exposing a mouse to major, sustained stress for a few days changes everything. CRF no longer enhances dopamine release, and the mouse avoids the novel object. Moreover, the CRF is now aversive: Spritz it into the nucleus accumbens, and the mouse now avoids the place in the cage where that happened. The researchers showed that this is due to the effects of stress hormones called glucocorticoids. A switch has been flipped; stimuli that would normally evoke motivated exploration and a sense of reward now evoke the opposite. Strikingly, those few days of stress caused that anhedonic state to last in those mice for at least three months.”

Sapolsky concludes:

“But meanwhile, these findings have an important implication. Life throws lousy things at us; at times, we all get depressed, with a small letter “d.” And most people—as the clichés say—get back in the saddle; prove that when the going gets tough, the tough get going. What then to make of people who are incapacitated by major depression in the clinical sense? Unfortunately, for many, an easy explanation is that the illness is a problem of insufficient gumption: ‘Come on, pull yourself together.’ There is a vague moral taint.”

The trauma of everyday stress is an important player in major depression. When combined with genetic history and childhood neglect or trauma, it can tip the applecart and result in what Andrew Solomon calls “The Noonday Demon”.   The takeaway is that the better we get at managing the “trauma of everyday life”, the better chance we have at preventing depression.

My worry is that the society we’ve created and the hectic lives we lead make the management of stress very difficult, indeed.

 

 

 

Opening Up About Depression

Steve Petrow writes in The New York Times, “Most people, even those who know me well, don’t see my depression. I’m a ‘high-functioning’ depressive, for sure, and perhaps an artful one, too, obscuring its symptoms with a mix of medication, talk therapy, exercise and knowing when to close the door on the world. And unlike my surgical scars (thank you, cancer), those left by depression are invisible.”

Read the News

Liz Swados’ Journey Through Depression

If you’ve ever suffered from depression, you know what a dark muck it can be.  Helpless and hopeless, this deadened state leaves people at the bottom of a dank well with no ladder out.

I’ve gone through major depression.  I count myself one of the 20 million in this country so afflicted.  I’ve gotten to know so many fellow sufferers over the years.  One I didn’t get the chance to meet, to my great chagrin, was author, composter and Tony-nominated playwright Liz Swados.  We had a few things in common – we both grew up in Buffalo (she left for a theater career in NYC years ago and I’m still here), a lawyer connection (her dad was one and I’m currently one) and we both struggled with depression on and off during our lives.

elizabeth_swados

Sadly, Liz died on January 5, 2016  of cancer at the age of 64 before I had the chance to meet her.

If you not aware of Liz’s work, you should be.  She’s the author of the book, My Depression: A Picture Book.

The book is a memoir in words and pictures of Liz’s journey through depression that is by turns poignant and funny.  Through her whimsical drawings, readers get a unique view of the experience of depression: from the struggle to keep her condition a secret, to the strange effects of ‘new’ drugs, to the small things that can trigger relapses.  At its heart, it is a gentle reminder fellow sufferers are not alone and that they can lead a fulfilling and happy life.

She’s also the creator of the brilliant HBO animated film, “My Depression (The Up and Down of It)” that appeared last summer.

Here’s what Liz wrote about the film:

“It takes us through a journey from the beginning of a depression, through the darkest symptoms and searching a person can do to try to find a cure, to discovering small bits of light, be them from anything – chocolate, yoga, therapy, medications… We didn’t come to any brilliant conclusions; we just went by our instincts and experiences. We have been showing it to various audiences and have found that many people identify with it, which is a true pleasure because I wouldn’t want to represent something so sensitive in a wrong way. I’ve received emails and all kinds of communications from people telling me that they feel simpatico with me, and that’s the best: to give someone an identity and a way to be not alone in a very empty, difficult time of life. I think the most important part of the film is the humor. Depression may not be funny to live through, but if you look at it in a certain way, if you look at yourself and others as creatures under some silly dark spell, it can help lift the weight.”

It’s so hard to describe to others who have never been through depression what it’s really like.  It’s tough, I think, because they really don’t have a reference point.  They’ve been through sadness.  But depression isn’t sadness – it’s an illness.

Liz’s book and film have done a lot of good to help others understand and, hopefully, offer more love and support.

But it’s also is a powerful visual journey for those who suffer.  It gives voice to an experience that so often, in it’s most miserable manifestations, mutes that voice.

The voice of our truest and most vital selves.

And it does it all with a panache of humor.

Thanks for everything you’ve done Liz and rest in peace.

No Longer Wanting to Die

From The New York Times, a powerful piece by Will Lippincott who writes, “When depressed, the self-esteem I presented to the world belied just how out of control I felt inside.”  Read the News

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